保留肾单位的肾肿瘤切除术72例报告

Nephron-sparing surgery (Report of 72 cases)

目的:探讨保留肾单位的肾肿瘤手术方法和疗效。方法:回顾性分析72例经开放和腹腔镜行保留肾单位的肾肿瘤患者的临床资料。开放手术53侧,平均手术时间140min;腹腔镜手术23侧,平均手术时间200min。术中出血量100～1200ml。一侧有漏尿者行保守治疗。结果:肾良性肿瘤随访38例,平均随访8年,3例非肿瘤原位再发。肾癌随访15例,5年存活14例,无局部复发;10年存活11例,1例局部复发。结论:保留肾单位的肾肿瘤切除术安全有效,选择性肾动脉栓塞阻断血管最有效,腹腔镜下可以完成保留肾单位手术。

Objective： To investigate the surgical technique and therapeutic effect of nephron sparing surgery for the treament of renal tumor. Methods：Clinical data of 72 patients with kidney neoplasms who received nephronsparing surgery were reviewed retrospective. Results： Open surgery was performed on 53 kidneys（ mean operation time 140 minutes）. Laparoscopic surgery was performed on 23 kidneys（mean operation time 200 minutes）. The volume of blood loss ranged 100 ml-200 ml. Leakage of urine happened in one patient and vanished after catheter drainage. Thirty eight patients with benign tumor were followed up for a mean time of 8 years, 3 patients were noted having new tumor in a different place. Fifteen patients with renal carcinoma were followed up, 14 patients survived for 5years,none local recurrence noted, 11 patients survived for 10 years, one patient having tumor recur rence. Conclusions：Nephron-sparing surgery is safe and effective. Selective thrombosis of renal artery is the most effective method of blocking blood flow . Laparoscopic operation can execute nephron sparing surgery.